Provider Demographics
NPI:1083910350
Name:LITMAN, EDWARD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:S
Last Name:LITMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 ACADEMY RD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1120
Mailing Address - Country:US
Mailing Address - Phone:215-637-5800
Mailing Address - Fax:215-637-8670
Practice Address - Street 1:10101 ACADEMY RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1120
Practice Address - Country:US
Practice Address - Phone:215-637-5800
Practice Address - Fax:215-637-8670
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023125L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice